Chapter Three:
The rest of the week flew by and before Susan knew it, it was Monday. Susan had spent the weekend getting organized. She calculated scores from Professor Hastings' grade book for each student to see how each student was faring. A large number of them were failing the course which in Susan's opinion was the fault of the professor and not the students. She'd know more in a few hours. Class was at 10:00am and Susan arrived to work at 8:00. She had two hours to get ready for her day before she had to leave for class. When Susan walked in the lab and went to her desk, she had to smile. Sitting right in the middle of her desk was a large red apple, a brand new box of chalk, a ruler, two red pens and a box of dry erase markers. There was a post-it note next to the items – "Good luck on your first day – The Team" it read. That was sweet, Susan thought. She started her daily maintenance and QC routine for the lab and when she was finished it was time to head to class.
She walked in the classroom where the students were already gathered. "Good Morning," she said. There was no reply as the students all stared her direction. She went to the white board at the front of the class, wrote her name and turned to introduce herself to the students. She handed out her syllabus and went over it highlighting the important parts like how many tests there would be for the remainder of the semester and how she would calculate their grades. When she was discussing homework one of the students raised his hand, "We've never had homework in this class."
"Really? That's interesting, because in Professor Hastings' grade book, there are homework grades for each chapter," Susan replied.
"We haven't done any," the student re-iterated.
"Oh. Well, you'll be doing homework from this point forward," Susan said. The class groaned. "Homework is important in Chemistry. General Chemistry is essentially an applied algebra class when you get down to it, with chemical knowledge thrown in for good measure. You have to practice the problems in order to pass the tests, the best way to do that is with homework and I'm not going to waste your time with it. If I assign homework, then I'm going to give you a grade for it," she explained. Susan continued as she glanced at Professor Hastings' class notes, "I see that so far you've had one exam and that right now you are covering….Yes?" she asked as another student lifted her hand.
"We haven't taken any exams," the student said.
"No exams?" Susan repeated.
"No," each class member said nearly in unison.
"What have you been doing in class?" Susan asked.
The entire class started talking at once; Susan lifted her hands to silence them. She pointed to a young lady in the front row. "We haven't really been doing anything. Professor Hastings came in and just talked to us about random stuff," she said. The rest of the class muttered in agreement.
"So, you haven't been discussing Oxidation-Reduction?" she asked.
The answer was a mix of head shaking and mumbled No's.
"Humph," Susan thought. "Well, let's see what you do know," she said taking out the text. She started out with the first chapter in the text; there was some familiarity with the material in that chapter. She went through each section of each chapter until she got to the point that the students were completely unfamiliar with the material – which didn't take long. It seemed that Professor Hastings started out teaching the class for about two weeks, but as his date for retirement loomed closer, he quit teaching. The students didn't even have a basic understanding of what a mole was much less anything else. Why were there grades for everything in his grade book? She thought to herself – he must have been covering his tracks. Surely he knew his replacement would figure out what he had done.
Time for class was nearly finished. "Well, I guess starting Wednesday we'll review chapters one and two and I'll hand out a worksheet for you to do to prepare you for your first test that will be over the first three chapters. Friday we will start chapter three and your first exam will be the following Friday. We've got a lot of catching up to do, so be prepared to put your nose to the grind stone over the next several weeks until we get caught up. See you all Wednesday," she said dismissing the class.
Shaking her head Susan gathered her things and walked to the conference room where most of the team was gathered while she pondered the last hour. Dr. House was at the counter pouring a cup of coffee when she came in and sat down. "So how did it go?" Chase asked noticing the perplexed look on her face.
"They don't even know what a mole is," Susan replied with a blank look on her face. She suddenly focused on the team and continued, "He didn't teach them anything, but his grade book is full of scores. He has grades for homework, but the students say that they've never had any homework. He also has an exam and quiz grades, but apparently the students haven't taken any exams or quizzes. The semester is nearly half over and the students don't know anything. According to his notes, they were discussing oxidation-reduction. I guess I need to go talk to Dr. Cuddy." Susan started to get up to leave when Dr. Cuddy walked in handing over a file to Dr. House.
"You have a case," she said and then turned to Susan. "What do you need to talk to me about?"
Susan explained the situation and then Cuddy said, "I have every confidence that you can correct the situation," and then walked out without further word.
Susan turned around and sat down again. "She must have been expecting something like this," Susan said to no one in particular.
"Obviously," House said as he walked over to the white board.
Infant – 3 months, female
Birth wt/ht – 5 lbs 11 oz/21", full-term
Current wt/ht – 9 lbs/21.4"
Gastroesophageal reflux
Irritable
"Wow, she's really tiny," Susan said.
"The technical terminology is 'Failure to Thrive'," said House. "We don't have any more information that; she's in NICU. Do a physical examination and get some history and meet back here in an hour." The doctors and Martha headed off to NICU and Susan left to go to the lab. She wasn't going to be able to do anything until the fellows returned with more information.
Chapter 3 - continued
House barged in to Wilson's office, without knocking as usual, sat down on the couch and put his feet up on the coffee table. Wilson continued writing in the file he was working on. "Susan had her first day of class this morning," House said.
"How'd it go?" Wilson asked as he continued making his notes.
"Apparently the prof was a slacker and didn't teach anything. She's going to have to start from scratch," House replied.
Wilson looked up from his paperwork, "It's nearly half way through the semester; do you suppose Cuddy knew? Is that why she moved up his retirement date?"
"I haven't talked to her, but it seems likely. She does have her spies," he paused, "You checked out that new nurse in ICU yet?" he said changing the subject.
"With a bod like that? Who hasn't?" Wilson replied.
MDMDMDMDMD
Back in the lab, Susan was sitting at her desk preparing a new set of notes for the first two chapters in the text. This was crazy, she thought. She decided that she would spend all of Wednesday reviewing chapter one and two and start chapter three on Friday. It was going to be difficult on the students to have to learn this much material in such a short span of time, but she didn't have much choice in the matter. There was a certain amount of material that had to be covered in the semester to prepare the students for their next class, so everybody was going to have to work hard – and that included her. Susan received a text indicating that the team had returned.
Chase was updating House when Susan arrived in the conference room. "She's tachycardic and tachypneic and extremely pale, but she doesn't have any dysmorphic features and there wasn't anything else remarkable about her physical exam."
Taub handed over two specimen vials to Susan, "I went ahead and pulled blood so you can run a complete CBC and a metabolic panel. I think she's probably rather anemic." Susan nodded as she took the vials from him and got up. The differential continued as she left the room and headed to the lab. These two series of tests were fairly simple and it wouldn't take long to have the results. She decided to go to the main lab to run the CBC on their flow cytometer since hers only ran a three part differential. She really needed to get an upgraded version, but the board hadn't approved her lab for any new equipment.
"Hi Susan, what brings you down here today?" the tech asked.
"I need to borrow your flow cytometer," she replied.
"Chris is out of the lab at a meeting at the moment, so you're clear. I've got a batch ready to go if you want to add that one to it," she said.
"I would actually. Do you mind if I put this one at the front? House needs the results quickly. It's a baby in NICU," Susan asked.
"He always needs his results quickly, but sure – go ahead," the tech said.
Susan prepared the vial and put it in the front of the specimen feeder, "There's a reason for that you know," she said.
"Yeah, because he's an impatient pain in the ass and has a god complex," the tech said.
"All doctors have god complexes, and yes he is impatient – but you know he gets all the tough cases. Most of his patients have already been referred through several other doctors before they get to him, so they tend to be more critical," Susan explained.
"That's probably true, but you have a soft spot for him so you're a little biased," the tech said.
"Can't deny that," Susan said.
Five minutes later, the specimen analysis was complete. Susan verified the results and started toward her own lab for the metabolic study, "Thanks," she told the tech as she walked out the door.
"No prob; see you later," the tech replied.
Back in her lab, Susan ran the metabolic study and printed the results. She headed to the conference room with the printouts.
The team still sat around the table when Susan brought in the lab data. Foreman looked over the CBC report. "Red blood cell count is low, you were right about the anemia," he said as he looked over at Taub. "Her neutrophil and monocyte counts are low, but her lymphocyte count is high."
Chase had picked up the metabolic study, "Her electrolytes are unremarkable, but the CO2 level is only 16."
Looking at Susan, House said, "Run lactate and pyruvate tests and just for kicks and giggles, do a screen for sickle cell trait. The rest of you get a bone marrow biopsy." Everybody left for their assigned tasks and House went into his office to think. It wasn't long before his phone rang, it was the duty nurse in the clinic, "You were supposed to be here 30 minutes ago," she said.
"I need a nap, get somebody else" House replied.
"Well, these patients need to see a doctor and you're on the docket for today; nobody else is available" she replied. "Besides, if you don't show up I'll tell Dr. Cuddy and then she'll be on your tail."
"Promises, promises," House replied as he hung up the phone.
Actually, for some reason today he didn't mind. It was just the sort of mindless boring work that might help him solve this case. He'd leave Susan in the lab this time since she was working on the case and he didn't feel like listening to Masters today, so he headed down to the clinic alone.
House took the file for the first patient and headed into Exam Room I. A young man sat on the exam table and said, "I'm really sick."
Dr. House noticed he was sweating and was very pale, "What are your symptoms?"
"I have a headache and my stomach really hurts," the patient said as he stopped to wipe his mouth, "and I keep drooling."
"Any weakness?" Dr. House asked
"Yes," the patient replied.
"It's probably a GI infection, when did this start?" House asked
"Yesterday," he said.
House took his temperature, no fever. This wasn't the run of the mill clinic patient and might even be a little bit of a challenge. House had the patient lay back on the table so he could palpate his abdomen. As he pressed his hands against the patient's stomach, he felt something square under the patient's t-shirt. House pulled up the t-shirt and found a nicotine patch. "When did you quit smoking?" he asked as he removed the patch.
"I haven't had a cigarette in three weeks. I'm using the patch to help with the cravings, but I'm starting to have issues," the patient said.
"Issues?" House asked
"Well, the package says to put a new one on every day and I'm running out of places to put them," he replied.
House rolled his eyes and told the patient to sit up. He removed the patient's shirt revealing numerous patches all over the patient's torso. Well so much for thinking this might be an interesting clinic patient. "Smoking is better for you than what you just did to yourself you idiot. Nicotine poisoning can kill you."
House left the room and sent a nurse in to remove the patches from the patient. "Make him strip down and get every patch off him – and wear gloves."
House grabbed the next file and went into Exam Room II.
MDMDMDMDMD
Susan set up the chemistry analyzer to run Lactate and Pyruvate as House ordered. Just as she was putting the specimen on the analyzer, Foreman walked into the lab with the bone marrow biopsy and handed it to Susan. "We couldn't do a full biopsy on the infant; see what you can get out of this aspirate."
"Will do," Susan said and walked over to counter that included a vacuum nozzle as Foreman left. Opening the cabinet below, she pulled out a small cylindrical funnel and a base with a glass frit filter. She put a membrane over the glass frit and dampened it with buffer before attaching the funnel over it with a clamp. She put the entire funnel apparatus in the top of an Erlenmeyer vacuum filter flask and hooked the glassware up to the vacuum line without turning on the vacuum. Having done that, she put more buffer in the funnel so that the membrane would remain damp while she prepared the specimen.
Dr. Foreman had brought the aspirate to her in a sterile conical 15mL tube. Susan added a few milliliters of sterile filtered PBS buffer to the tube and gently agitated the tube to suspend the cells and then filled the tube completely with more buffer and agitated the tube again.
Having created her cell suspension, Susan then walked back over to the counter where the vacuum and filter apparatus was set up. She turned on the vacuum slightly so that the buffer that was sitting in the funnel filtered through the membrane. She then poured half the cell suspension into the funnel and filtered it through, the membrane catching all the cellular debris, and cut off the vacuum so that air wouldn't dry out the membrane. She set the remaining cell suspension aside and took apart the filter apparatus. She removed the membrane from the funnel with a pair of forceps and laid the membrane upside down on a glass microscope slide. She then removed the membrane from that slide and touched it to second slide. She sprayed both slides with a fixative and put them in a rack to dry. She repeated the process with the remainder of the cell suspension, a second membrane and two more slides. While the slides were drying, Susan prepared her staining station for a Pap stain. Once the slides were ready, she started the staining process on the first two slides and kept the second two slides for later, in case they needed to look at something else.
Looking through the microscope, Susan noted that the cellularity of the specimen was fine. Unfortunately, she wasn't going to be able to be of much help in the interpretation of this one. She wasn't nearly as familiar with cytology as she was histology. Certainly she recognized the various cell types, but she was unfamiliar with morphology details. Susan hated to fail House at all, so she decided to be pro-active and created smears from the whole blood she had used to run the CBC earlier. That way if the doctors needed to see the red blood cell morphology as well, it would be available for them and she wouldn't look like a complete idiot.
The chemistry analyzer beeped indicating that the analysis for lactate and pyruvate was finished. She went over to the analyzer and printed the results. Both values were high for an infant. Susan had forgotten to run the test for Sickle Cell and so she started that process and then called the conference room.
"Foreman," Dr. Foreman said as he answered the phone and put it on speaker.
"I have the slides ready for the bone marrow aspirate if you guys want to come down here," said Susan.
"Just image the pertinent areas and send the images to us like you usually do" said Chase.
"Well, that's the problem. I don't know bone marrow morphology well enough to be sure I'm sending you the images you need to see," Susan admitted hesitatingly.
Foreman lifted one eyebrow in response and said, "We'll be right down."
He hung up the phone and the fellows filed out of the room and headed to the lab.
Susan turned on the video camera to the microscope and set it up for the fellows and then slipped around to the other side of the counter to check on the Sickle Cell analysis. The fellows and Martha filed into the lab and went right over to the microscope and the video output. Foreman looked in the scope and moved the slide around on the base of the scope. "Plenty of cells, hmm – looks like there is a decreased myeloid to erythroid ratio, Also some abnormalities in the cytoplasm of the erythroids. Susan, did you happen to create a smear from the whole blood specimen?"
"In the rack right next to you," Susan replied. At that moment the results from the Sickle Cell test printed out, "Negative for Sickle Cell," Susan added.
Foreman replaced the bone marrow aspirate slide with the blood smear, "Red blood cells are of unequal size."
"Do you see those tear-shaped ones?" Susan asked
"Yes, and some fragmented cells as well …." Foreman started and everybody's pagers went off.
"I got it," Chase said and ran out the room with Martha following close behind.
"What?" Susan asked.
"Patient's seizing," Taub said as House walked into the lab. House looked at the video feed of the blood smear as Foreman continued to scan the slide.
"What did the bone marrow show?" House asked. Foreman explained what he had seen on the bone marrow aspirate. "What were the levels of the Lactate and Pyruvate?" he asked Susan.
"High, 9.1 and 0.29 respectively," Susan answered.
House sat down on the lab stool and stared off into space for a while. Given the seizure, whatever it is, it's affecting her brain as well." House looked over at Foreman, "Get some of her cerebrospinal fluid for a GC analysis." Foreman and Taub walked out of the lab and Susan walked over to her hospital directory and started perusing through the medical school's research labs. "What are you looking for?" House asked.
"No Gas Chromatograph in here, need to find somebody who has one," she said.
"Can you do the analysis?" House asked
"Just like riding a bike ….," Susan's voice trailed off as she continued to look through the directory and found what she needed. Susan lifted the phone to make the call and then turned to House, "I think I'm going to get some of the patient's urine and run that through before I run the spinal fluid if that is OK. I don't want to waste any of the CSF fluid if there are any issues with the analysis."
House nodded his approval and left the lab.
Susan hung up the phone and headed over to NICU. Since she wasn't allowed in the room dressed as she was, she knocked on the glass door. Martha came over to the door and Susan asked how long they thought they would be, "They're just now prepping for the procedure, it'll probably be an hour or so before they have the specimen for you," she said.
Susan asked her to get a urine specimen as well and then said, "I haven't had anything to eat all day; I'm headed down to the cafeteria for a few minutes. Put the specimen in the lab refrigerator if I'm not back in the lab by the time you're finished."
Susan found an empty booth and sat down with her rather late lunch. As she bit into her sandwich, Dr. Wilson sat down across from her bearing a cup of coffee he had just purchased for himself. At least with Dr. Wilson, she didn't have to worry about half of her lunch disappearing she thought. "Hey boss, what's up?" she asked after she swallowed.
"Just saw you and thought I would join you for a bit," he said.
The two sat in an awkward silence for a moment, when Susan said, "We have an interesting case with a patient in NICU."
"I heard something about it," he replied.
They fell silent again.
"I also heard that you got a surprise with your chemistry class," Wilson said.
"Mmm Hmm," Susan acknowledged while chewing. After she swallowed she said, "Professor Hastings was apparently quite a character." She paused, "I think the school is better off without him, good thing he retired early."
"I think he was encouraged to leave early, but that's only my theory – no evidence to back it up," he said.
"He was a condescending womanizer at the very least," Susan said, "and lazy on top of that."
"Why do you say he was a womanizer?" Wilson asked.
Susan told him about the interaction she'd had with him when she went to pick up his class notes. "He also gave the men in the class higher grades than the women – except for one. If she is who I think she is, then my theory will be confirmed, but I haven't figured out who everybody is yet. Of course, the grades are irrelevant since he didn't teach them anything. I have to start over from scratch."
"Not much time to get that done," Wilson said.
"No, there isn't," she replied.
The two fell silent again and then Dr. Wilson shifted uncomfortably in his seat and then asked, "Susan, are you doing anything Saturday night?"
Susan looked up at Dr. Wilson, "Actually yes, but why?"
"I was just wondering if you wanted to catch a movie or something," Wilson said with a little trepidation.
"Oh. Well, as you said there isn't much time to get everything done that I need to do for the class and I was planning on spending most of the weekend working on that. I also have some furniture shopping I need to find time to do," Susan said.
"Ugh, I hate furniture shopping," Wilson said.
"Well, it's not my favorite either, but it needs to be done," she said. "I'm replacing my bedroom suit – downsizing."
"Downsizing?" Wilson asked
"Well my husband is gone and since I'm not planning on replacing him, I'm replacing the king size bed for something quite a bit smaller. It'll be nice having more actual room in the room without the bed taking up so much space," Susan said as nonchalantly as possible hoping that he would take the hint without taking it personally.
"I see," Wilson said.
Susan could see a combination of emotions on Wilson's face. She decided to give him a carrot to make him feel better without letting on that she was at all interested, which she wasn't. "I was wondering if you could help me out."
"With what?" he asked.
"This patient that we have; I was asked to stain a bone marrow aspirate specimen and instead of sending images of the relevant areas like I do with histology specimens, I had to have Dr. Foreman come down and look at the slides for him to evaluate them himself. I'm not familiar enough with what I'm looking at to feel confident that I would be sending them the images they need to see. I was wondering if you would mind showing me what I need to be looking for on bone marrow biopsies," she explained.
"I would be happy to do that Susan," Wilson said with a smile. "How about we start next week after you get settled with your class?"
"Great! Thanks," she said as she got up to leave. "I've got to get back to the lab. They should be finished getting the CSF specimen by now."
When Susan returned to the lab, the both the CSF and urine specimen were sitting in the refrigerator. Susan walked over to her desk to call the research lab she was going to visit to borrow their gas chromatograph when she noticed her 'messages' light flashing on her phone. She pressed the button to listen to the message – it was the research lab. The GC was down and the technical representative for the instrument was working on it, but it probably wouldn't be ready until tomorrow. Susan called the lab and asked them if there were any other GC's in the facility and was told that theirs was the only one that had been up and running. If she tried to use any of the others, she would spend just as much time getting it ready to analyze as it would take for their GC to be repaired. Susan hung up the phone and called Dr. House to relay the message.
House hung up the phone, his disappointment evident on his face. "What?" asked Wilson, who had come into his office after his visit with Susan in the cafeteria. House told him what Susan had said, "So you'll have to wait until tomorrow to get your answer."
"I'm not sure that is even going to give me an answer, I'm grasping at straws. Every time I think I have an idea, the baby shows another symptom that sends me in another direction. Babies are such a challenge. They can't tell you what hurts or what is bothering them." He said.
"If she could, she'd lie anyway," Wilson replied.
House nodded circumspectly, "True."
"I asked Susan out for this Saturday night," Wilson offered after a moment.
House's head popped up toward Wilson with a very protective look on his face.
"Whoa! Defensive. Don't worry, she turned me down flat," he said.
"Smart girl," House said.
"Hey! I'm not such a bad choice," Wilson said. "Besides, she's kinda cute."
"Yeah – well, you need to focus your 'kinda-cute-radar' elsewhere, besides Susan's not nearly needy enough for you," House said.
"She did throw me a bone however," Wilson said.
"What do you mean? A bone?" House asked.
"She wants me to show her what to look for in bone marrow biopsies. She was disappointed with herself by not being able to do more than just prepare the specimen and wants to rectify that," he paused, "You know, she really does care for you," Wilson said.
"Giving me her liver kinda showed me that," House replied.
"I think she worries that she's going to be a disappointment to you," Wilson said.
"Well, that would be in her character," House said thinking of their past conversation. "She's not a disappointment."
"Maybe you should tell her that from time to time," Wilson advised.
"That would be out of my character," House replied.
Chapter 3 - continued
Susan was at a loss of what to do for the patient. She was stuck without having the GC available, so she decided to spend time on the worksheet she was preparing for her students for their review of the first two chapters of the text before it was time to leave for the day.
After a couple of hours, she walked up to the conference room. Out in the hall Susan could see that the team was gathered around the conference room each of them looking through various texts. Dr. House was in his office balancing Ball-y on his cane and tossing it against the wall – typical puzzle thinking behavior. She decided not to interrupt them and turned to go back to the lab when all four fellows ran out of the room passing her in the hall. "Patient's crashing!" Martha explained as she ran by.
"Great!" thought Susan sarcastically. "I wish I could get that analysis done now." She started to head back to the lab when she heard Dr. House.
"Susan, c'mere," he said poking his head out of his door.
"Oh crap," she thought to herself. "He upset I can't get that analysis complete." Susan reluctantly followed House back in his office waiting for the barrage of words to begin.
"I'm starting to think genetic with this patient….," he began. "What's wrong?" he asked suddenly when he saw her face.
"Oh, nothing – you were saying?" Susan asked having been surprised when he hadn't started in on her for not being able to do the GC analysis.
"I'd like to get a mitochondrial DNA analysis done," he said.
"We'll have to send out for that one," Susan said. "There's a lab in Bethesda that does them."
"Find out what they need and send the sample over to them for analysis. Tell them the patient's critical and to work quickly," he said.
MDMDMDMDMD
Susan got off the phone with the lab in Bethesda and sighed, this wasn't going to be pleasant for the baby. As she started to head to NICU to talk to the fellows, her phone rang; she turned to answer it. "Diagnostics Lab, this is Susan," she said. Susan listened for a moment, "That's great! I'll be right there." Susan hung up the phone and went over to the refrigerator to get the urine and CSF specimens and left the lab. Before heading over to Professor Jones' lab to run the CG analysis, she stopped by NICU and told Chase what she needed for the mtDNA analysis and asked him to wait to do the biopsy until she returned.
Two hours later, Susan was back with the GC analysis for the CSF fluid and urine. Lactate levels were very high in both specimen types. She called Chase and he told her to meet him in pediatric surgery in 30 minutes. Susan walked down to the main laboratory calling Taub as she made her way to the tissue culture lab. She had just hung up with Dr. Taub when she walked in the lab. The tech in the lab was splitting a cell line to encourage cell growth. Susan had never met this tech and she introduced herself and asked the tech for a Dewar flask and some liquid nitrogen after explaining the situation. Having what she needed, Susan started to rush to surgery to get there before all the liquid nitrogen evaporated, but was stopped by Chris, the clinical lab manager who was blocking the door.
"Why are you here?" he asked as he stepped inside the tissue culture lab. Susan explained the situation to the lab manager, but he wasn't having any of it, "I don't care what the situation is, Dr. House has his own lab and his own special tech, you don't need to be coming down here to use our equipment whenever it suits you or to steal any of our supplies.
Susan tried to explain the urgency of the situation and that they could work this out later, but the lab manager was being difficult. During the course of the conversation however, Susan managed to work her way around him and past the door. As he was starting to lay into her, Susan thought, I don't have time for this, and escaped out of the lab and down the hall with the manager yelling after her. "I don't want to see you in my lab again!"
Susan was angry, she hadn't done anything wrong. She certainly hadn't stolen anything, she had asked politely. She decided to put the whole ugly mess behind her and once in surgery, Susan scrubbed up and dressed as quickly as she could and entered the room. Chase and Foreman were ready to obtain the skeletal muscle biopsy. Not bothering with an explanation, she apologized for her tardiness. As she approached, Chase took the biopsy. Susan opened the Dewar flask and Chase dropped the muscle tissue into the flask in order to flash freeze the biopsy. As quickly as she had arrived, she left, disrobed the surgery scrubs and practically ran to the lab.
Once in the lab, Susan removed the tissue from the liquid nitrogen and placed it in a small sample vial and quickly placed it in a container of dry ice that Dr. Taub had gotten for her while she was getting the liquid nitrogen from tissue culture. Susan packed the box and called the hospital courier to pick up the specimen and hand-deliver it to the Bethesda laboratory. The lab had agreed to start working on the specimen as soon as it was received. Still, it was going to take a minimum of three days to get the results.
The team gathered in the conference room and Susan presented the results of the GC analysis. "The urine specimen contained a lot of lactic acid and several other organic acids," she said as she handed out copies from the print outs to Dr. House and the team. "And the CSF fluid has elevated alanine levels. I've sent the biopsy specimen over to a lab in Bethesda for the mitochondrial DNA analysis, but at minimum it's going to be three days before we have a result."
"I want it faster than that," House said
"It's not going to happen," Susan replied shaking her head.
House flashed an angry look her way. "Find a way," he said.
"I've already talked to them Dr. House. They said they would start working on it as soon as they get the specimen. I've sent the hospital courier to deliver it by hand to them, there isn't anything else I can do to get the results any faster," she said.
House was angry at Susan for arguing with him, "I need those results."
"It is what it is Dr. House; the process can't go any quicker. It takes time to go through each step…" Susan started getting annoyed with him for asking the impossible.
"Quit arguing with me and take care of it," House said quietly as his anger continued to mount.
"You're being unreasonable," Susan argued.
House's face started turning bright red as he glared at Susan. Suddenly her temper got the better of her; "Fine!" she said slamming her fist on the table. "I'll call them and be an ass like you and see if that will magically compress time!"
Susan stormed out the conference room and started to the lab. As the elevator door opened, Dr. Wilson stepped out and noted the expression on Susan's face, "What!" she said. Wilson put his hands up in front of him defensively and shook his head in answer. By the time she got to the basement where the lab was located, tears were coursing down her cheeks. She hadn't lost her temper like that in a long time. She wiped the tears from her face and picked up the phone to call the lab director at the facility.
By the time she had gotten off the phone, she had convinced the lab director to have someone working on the specimen non-stop until the analysis was finished. It was going to cost them a lot more in order to cover the overtime costs and it would only take 8 hours off the turn-around time – but there wasn't anything else she could do.
It was late and Susan was tired, she decided to go home.
MDMDMDMD
"Wow! She's got quite a temper," Chase said as they watched her storm out of the lab.
"Can it!" House said, "Keep the infant on 24-hour watch and treat the symptoms as they come, let me know if there are any other changes." House rose from the table and went into his office to gather his things before he left for the night. The team talked amongst themselves to determine who would get the first watch and the rest left to get some rest before their shift began.
Just as House was getting ready to walk out the door, Wilson walked in, "Everything alright?" he asked, "I just saw a very upset Susan pass me in the hall."
"I'm fine, we just got into an argument" House replied rather downcast.
"You don't look fine," Wilson said.
"She's never argued with me before," House said as he sat back down.
"This is actually a good thing House," Wilson said.
"Oh? Why is that?" House asked.
"Remember what I told you before; she's worried about being a disappointment. This shows she's starting to stand up for herself. Siblings argue House, don't worry about it, it'll be fine," Wilson explained. "Bowling tonight?"
House nodded, "I'll meet you there."
MDMDMDMD
Susan felt horrible. She felt like she was failing him at every turn with this case and on top of that she lost her temper – again. When was she going to learn to keep it under control? Her cell phone rang and she looked at the caller ID, it was Greg.
"Yeah?" she said quietly when she answered the phone.
"You call the lab?" he asked
"Yes, they said they would try," she said.
House hung up the phone without replying as he headed to the bowling alley.
Susan tried to work on her lecture notes, but was unable to concentrate. She watched TV, but couldn't get into the show. Her mind kept drifting to her argument with Greg; it was stupid and she shouldn't have lost her temper. She decided to take a soaking bath and try to relax. It had been a long day and tomorrow she had a lot to do preparing for her second day of class to try to speed-teach her class what they should have learned over a month ago. An hour later, Susan had finished her bath and was ready for bed when there was a knock on the door. She slipped on her robe and looked out the peep hole. She opened the door and House walked in and shut the door behind him.
Susan walked over to her couch and sat down not wanting to look at him for fear she would start crying again. House followed her and sat down facing her, "You still mad?" he asked. Susan shook her head still not able to look him in the eye.
"They promised to have somebody working on it non-stop until the analysis is complete, but they don't think it'll speed things up much," Susan said quietly.
House sat quiet for a moment and then asked, "How are you coming with your class preparation?"
Thankful for a change in topic, Susan look up at him. "I have a full set of notes ready to cover the first two chapters of the text. I'm also creating a worksheet for the students to use to help them get through the material. I'm hoping to get through all of the material Wednesday so that Friday we can start covering chapter three which introduces the mole. It's a hard concept for a lot of people, so I want to be able to take two lecture periods to cover it before we review everything to get them ready for their exam next Friday."
Susan and House spent the next half hour in small talk about basic chemistry and by the time House was ready to leave Susan had a couple more ideas about how to present the concept of moles to her students. House got up and started toward the door. Susan walked with him and just as he was about to open the door, Susan touched his arm. He turned around to face her and Susan looked up to meet his eyes. Tears started forming in her own when she suddenly wrapped her arms around his waist and buried her head in his chest, "I'm sorry," she said as the tears started to flow.
House was startled, but held his ground. He was uncomfortable with the emotion and the contact, but slowly brought his cane-less hand up and set it on her back in a comforting gesture, "I know," he said quietly, "Me too."
Susan released her hold and stepped back. House opened the door and walked out of her apartment. Feeling better, Susan wiped the tears that had fallen down her cheeks and went to bed.